Inflammation is caused by tissue injury consisting of complex reactions involving vascular and connective tissues. Tissue damage may result from microbial invasion, auto-immune processes, tissue infection, allograft rejection, and such hurtful and/or destructive external influences as heat, cold, radiant energy, electrical or chemical stimuli, and mechanical trauma. Tissue damage may involve any part of the human body such as the joints (arthritis), bowels (inflammatory bowel disease), and lungs (pulmonary inflammation). Whatever the cause or bodily site, inflammatory responses to tissue damage are quite similar, consisting of complicated functional and cellular adjustments involving microcirculation, fluid shifts, and inflammatory cells (leukocytes). When tissue damage occurs, soluble chemical substances are elaborated which initiate the inflammatory response. Inflammation can be mild and self-limited or prolonged and seriously debilitating and chronic.
Numerous drugs have been developed to fight inflammation in humans. The most prominent in current treatment are anti-inflammatory steroidal drugs, corticosteroids and non-steroidal anti-inflammatory drugs (“NSAIDs”) such as salicylates. While these drugs are generally effective, they often have adverse side effects.
Corticosteroids are powerful anti-inflammatory drugs that suppress both acute and chronic phases of inflammation. Unfortunately, corticosteroids also suppress the immune response and sometimes decrease certain essential cell repair processes. Use of excessive doses or/and long term use of corticosteroids may lead to hypercorticism or/and suppression of hypothalamic-pituitary-adrenal function. Corticosteroids must generally be given by injection and are not effective via oral administration.
A topically active corticosteroid may be effective in treating bronchial asthma. While topically active corticosteroids administered by metered-dose inhalation have greatly reduced some adverse side effects of steroid therapy in treating bronchial asthma, a large portion of an inhaled corticosteroid dose is swallowed by the patient. The swallowed portion may reach the systemic circulation through the gastrointestinal tract and cause adverse systemic side effects including high blood pressure, cataracts, glaucoma, and worsening of diabetes. Intranasal corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculosis infections of the respiratory tract, untreated local or systemic fungal or bacterial infections, systemic viral or parasitic infections, or/and herpes simplex.
NSAIDs such as salicylates, phenylbutazone, indomethacin, ibuprofen, and naproxen have been tried in order to avoid adverse side effects in the treatment of uveitis. The results have generally not been satisfactory. Furthermore, NSAIDs commonly affect the gastrointestinal tract, the liver, kidney, spleen, blood, and bone marrow and produce adverse side effects such as edema, nausea, stomatitis, epigastric pain, and drug rash. NSAIDs are typically not effective in treatment of some chronic inflammatory disorders including asthma and lower back pain.
A pathogen is an infectious biological agent, sometimes referred to as a germ, which causes disease or illness to its host. Many medical advances, such as vaccination, antibiotics, and fungicides, have been used to safeguard against infection by pathogens. Nevertheless, pathogens continue to threaten human life. Primary pathogens are bacteria, eukaryotes, prions, and viruses.
Bacteria constitute one of the smallest organisms containing all the material required for growth and self-replication. A bacterium has a rigid cell wall surrounding a cytoplasmic membrane that encloses a single naked chromosome without a nuclear membrane. The cytoplasmic membrane consists primarily of a bilayer of lipid molecules.
Bacterial pathogens cause infectious diseases such as tuberculosis, cholera, and syphilis. The most common fatal bacterial diseases are respiratory infections. Some bacterial pathogens, such as staphylococcus, can cause skin infections, meningitis, pneumonia, and even overwhelming sepsis, a systemic inflammatory response producing shock, massive vasodilation, and death. Opportunistic bacterial pathogens cause disease mainly in patients suffering from immunosuppression or cystic fibrosis.
Bacterial infections can be treated with antibiotics, classified as bacteriocidal if they kill bacteria and as bacteriostatic if they prevent the bacteria from multiplying so the human immune system can overcome them. There are many types of antibiotics. Each type of antibiotic inhibits a process whose pathogen is different from that found in the host. The effectiveness of individual antibiotics varies with the location of the infection, the ability of the antibiotic to reach the site of infection, and the ability of the bacteria to resist or inactivate the antibiotic.
The adverse side effects of antibiotics are varied, and range from fever and nausea to major allergic reactions. One of the more common adverse side effects is diarrhea, sometimes caused by the anaerobic bacterium clostridium difficile, which results from the antibiotic disrupting the normal balance of intestinal flora. Other adverse side effects may result from interaction with other drugs, such as elevated risk of tendon damage from administration of a guinolone antibiotic with a systemic corticosteroid.
Antibiotics are among the drugs commonly misused by physicians. For instance, antibiotics are often misapplied for combating viral respiratory tract infections. Widespread and injudicious use of antibiotics has led to the emergence of antibiotic-resistant pathogens. This poses a serious threat to public health. The antibiotic-resistance problem raises a need for increased efforts to seek antibacterial agents effective against pathogenic bacteria resistant to current antibiotics.
Fungi are eukaryotic pathogens similar to bacteria. One of the differences is that fungal nucleic acid, consisting of multiple chromosomes, is enveloped by a nuclear membrane. In some fungi (as in some bacteria), the cell wall is surrounded by an external capsular polysaccharide which, in at least the case of bacteria, protects the pathogenic microbe from phagocytosis and thereby plays a major role in determining virulence.
Fungi are responsible for numerous diseases such as aspergillosis, psoriasis, aspergilloma, and dandruff. Symptoms of aspergillosis include hemoptysis (coughing up blood), blood clots, chest pain, delirium, and fever. Persons severely infected with aspergillosis may also develop kidney and liver failure. Voriconazole is commonly used to treat aspergillosis. However, a large percentage of persons treated with voriconazole report visual disturbances that generally occur thirty minutes after administration and last for about thirty more minutes. Consequently driving or risky tasks should be avoided. Other common adverse side effects associated with voriconazole include fever, nausea, rash, overwhelming sepsis, and respiratory disorders. Corticosteroids which have the above-mentioned adverse side effects can be used to treat allergic bronchopulmonary aspergillosis. 
Symptoms of psoriasis include red patches covered with silvery scales of the skin, dry cracked skin that can bleed, burning, itching, pain, disfiguring nails, and swollen and stiff joints. Psoriasis is commonly treated with corticosteroids. While corticosteroids can be effective, they have the above-mentioned adverse side effects, including a risk of suppressing the immune response and a decrease in many aspects of essential cell repair processes. Corticosteroids often irritate normal skin, cannot be used for long periods of time, and have an unpleasant odor. Additionally, abrupt withdrawal of corticosteroids can cause an aggressive recurrence of the condition.
Individuals infected with aspergilloma, a serious lung disease, commonly do not have significant readily noticeable symptoms. An aspergilloma infestation may be present for years until it is diagnosed sometimes due to coughing up blood. Medications to treat aspergilloma have not been shown to eradicate the fungi. Surgery can be used to treat aspergilloma and is often the only choice to control bleeding in life-threatening situations. Aspergilloma surgery generally has a high risk of major complications including changes in local blood flow, hemorrhage, inflammation, infection, loss of function, and scarring. Conventional dandruff treatments are discussed below.
Spores are metabolic byproducts of the life cycle of some bacteria and fungi. Bacteria produce endospores located within the cytoplasm of the parental cells. Bacterial spores may occur when food is uncooked. This can cause food-borne illnesses such as heavy nausea, vomiting, and abdominal periods.
Fungi produce a variety of exospores, including aspergillus spores and conidia spores. If large amounts of aspergillus spores are inhaled, aspergillosis may occur. Aspergillus spores are one of the most common causes of fungal ear infections which can cause pain, temporary hearing loss and, in severe cases, damage to the ear canal and tympanic membrane. Conidia spores are non-motile fungal spores present in the air. An average person inhales 40 conidia per hour. Conidia often leads to immunocompromise, i.e., the immune system is not strong enough to fight off the fungi as the lungs are colonized, resulting in pulmonary infection.
Spores are highly resistant to physical and chemical agents. Research is ongoing to find safe and effective treatments for debilitating conditions produced by spore pathogens.
In medical parasitology, the term “parasite” means a eukaryotic pathogenic organism. Hence, protozoan and metazoan infectious agents are classified as parasites whereas bacteria and viruses are not. Many parasites, such as protozoa, fleas, and worms (helminths), carry disease or cause sores or lesions which can become infected. Protozoan parasites that can cause human disease include amoeba entamoeba histolytica, the cause of amoebic dysentery and liver abscess as further discussed below.
Parasites live on or in their hosts from which the parasites get some or all of their nourishment. Although parasites are generally harmful to their hosts, the damage ranges widely from minor inconvenience to debilitating or fatal disease. An ectoparasite, such as a louse, tick, or leech, lives or feeds on the outer surface of the host's body. Ectoparasites do not usually cause disease themselves. However, they are frequently a vector of disease. For example, tick parasites transmit organisms that can cause diseases such as Lyme disease as discussed below. An endoparasite lives inside the body of its host. Endoparasites include organisms such as tapeworms, hookworms, and trypanosomes that live within the host's organs or tissues as well as organisms such as sporozoans that invade the host's cells. Endoparasites commonly cause malaria as discussed below. Many parasites have extremely specialized reproductive systems and complex life cycles involving more than one host.
Amoebiasis, an infection caused by the protozoan parasite amoeba entamoeba histolytica, is contracted by ingesting water or food contaminated with amoebic cysts. Symptoms of amoebiasis include mild diarrhea to severe dysentery (diarrhea with blood and mucus), and liver abscess. Metronidazole is used to destroy amoebae that have invaded tissue. However, metronidazole produces adverse side effects such as nausea, diarrhea, and metallic taste. High doses and/or long-term systemic treatment with metronidazole is associated with the development of furry black tongue, leukopenia, neutropenia, increased risk of peripheral neuropathy, and central nervous system toxicity. The International Agency for Research on Cancer lists metronidazole as a potential human carcinogen.
Lyme disease is primarily caused by the bacterium borrelia and is contracted through the bite of infected ixodes ticks. Symptoms of Lyme disease include fatigue, fever, malaise, muscle pain and soreness, and erythema migrans (circular rash). Persons diagnosed with Lyme disease need to be treated immediately to avoid systemic complications in the central nervous system and heart. Lyme disease is typically treated with antibiotics such as doxycycline which can be effective. The adverse side effects of antibiotics are discussed above.
Malaria, a vector-borne infectious disease widespread in tropical and subtropical regions, is caused by the parasitic protozoa plasmodium. Symptoms of malaria include anemia, arthralgia, convulsions, fever, retinal damage, headache, hemoglobinuria, shivering, and vomiting. Other symptoms include hepatomegaly, hypoglycemia, hemoglobinuria with renal failure, splenomegaly, brain damage, and coma sometimes leading to death. No vaccine is currently available for malaria. Malarial infections are treated with anti-malarial drugs such as chloroquine or pyrimethamine. Drug resistance is increasingly common, especially for chloroquine. Pyrimethamine may deplete folic acid resulting in hematologic side effects and hypersensitivity reactions, leukopenia, and hematuria. When used with a sulfonamide, pyrimethamine may also cause atrophic glossitis, cardiac arrhythmias, megaloblastic anemia, and hyperphenylalaninemia.
A prion is an infectious agent generally made solely of protein and lacking nucleic acid. Prions are believed to infect and propagate by refolding abnormally into a structure which converts normal molecules of the protein into an abnormally structured form. More particularly, all known prions are believed to infect and propagate by forming an amyloid fold in which the protein polymerizes into a fiber with a core consisting of tightly packed beta sheets. It is often assumed that the diseased form directly interacts with the normal form to make it rearrange its structure. This converted structure is stable and accumulates, causing tissue damage and cell death.
Prion infectious diseases include transmissible spongiform encephalopathic diseases such as Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, fatal familial insomnia, and kuru. Alpers' syndrome may also be a cause of prion diseases. All of these prion-caused diseases affect the structure of the brain or other neural tissue and are fatal. Prions are generally quite resistant to denaturation by protease, heat, radiation, and formalin treatments, although potency or infectivity may be reduced. Ozone sterilization has shown some effectiveness in treating prion infectious diseases.
A virus consists of a single nucleic acid, either deoxyribonucleic acid (“DNA”) or ribonucleic acid (“RNA”), and a protein shell or coat surrounding the nucleic acid. A complete viral particle is called a virion. Some viruses contain lipids and carbohydrates. Virions lack constituents fundamental for growth and multiplication, i.e., they never “grow”. Virions are by themselves metabolically inert. Virions replicate only after cell-host invasion, and therefore are obligatory intracellular parasites. Hence, a virus is more than a simple nucleoprotein (a chemical substance), but not quite a microbe (a living entity). In other words, a virus is slightly short of the threshold of life as commonly defined.
A virus uses the machinery of a host cell to reproduce and resides within the host cell. Consequently, viruses are difficult to eliminate without killing the host cells. It is believed that viral infections trigger inflammatory responses which do not respond to anti-viral drugs.
Patients often ask for, and physicians often prescribe, antibiotics. While antibiotics destroy or prevent the growth of bacteria, antibiotics are useless in treating viral (and fungal) infections. Their misuse in treating viral diseases is one of the causes of antibiotic resistance to bacteria. Nevertheless, the prudent course of action in life-threatening situations is to begin antibiotic treatment while waiting for test results to determine whether a person's symptoms are caused by a viral or bacterial infection.
The alternative to drug treatment is a vaccine to prevent infection. Vaccines can be active or passive. An active vaccine causes the body to produce antibodies that create an “immune response” against an attacking organism. A passive vaccine generally consists of pre-produced antibodies, e.g., from a mouse, rabbit or monoclonal antibody-producing cell line, which recognizes and attacks the virus, without the person's body doing anything. That is, the body does not have to produce an immune response.
There are various ways to provide vaccination against a viral disease. One way is to inject a person with a preparation of killed or seriously weakened (attenuated) virus. The problem with this approach is that a catastrophic may result if, for some reason, the virus “catches” and the person actually contracts the viral disease.
The injection approach has been investigated for treating acquired immune deficiency syndrome (“AIDS”) caused by human immunodeficiency virus (“HIV”) but with limited success. The resultant immunity is typically sufficient to provide protection against individual isolates of HIV, but not to HIV from any source. This is primarily because the coat proteins on the surface of the HIV particles are inherently variable and can even vary from one infected person to another. The vaccination injection approach is thus unsatisfactory because the person is at risk for catching AIDS and because the vaccine does not guarantee protection.
More generally, vaccines do not guarantee complete protection from many diseases, particularly viral diseases. Even after vaccination against a particular disease, a vaccinated person may still get the disease due to the host's immune system not responding adequately or at all. This may be due to a lowered immunity in general resulting, for example, from diabetes, steroid use, or HIV infection or the person's immune system lacking B-cells capable of generating the requisite antibodies.
Additionally, the strain of a disease contracted by a person may be different than the strain vaccinated against. In this regard, some viruses such as common cold and influenza viruses can mutate and are highly efficient at mutating. The mutated form of the virus may be so different from the form vaccinated against that the immune system is unable to defeat the infection. The disease is, however, often at a milder level in a person vaccinated against the disease.
Hepatitis is an inflammation of the liver characterized by the latency of inflammatory cells in the tissue of the liver. A virus usually causes hepatitis. The most common viral strains are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E. Hepatitis can also arise from non-viral sources such as autoimmune conditions (systemic lupus erythematosus), metabolic diseases (Wilson's disease), hereditary factors, primary biliary cirrhosis, toxins, and drugs (paracetamol and amoxycillin). A notable toxic cause of hepatitis is alcohol. The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis, i.e., scarring of the liver.
Some people with viral hepatitis have no signs of the infection. Viral hepatitis can be self-limited and thus go away on its own. For other people, symptoms of fever, vomiting, diarrhea, dark-colored urine and pale bowel movements, jaundice, and profound loss of appetite can occur. When chronic or life-long infection of hepatitis ensues, the liver swells and damage occurs. In addition to cirrhosis, this can lead to liver failure and liver cancer.
Hepatitis A can be prevented by vaccination with a high success rate. A hepatitis A vaccine contains inactivated hepatitis A virus that provides active immunity against future infection. If a booster vaccination is given six to twelve months after the initial vaccination, protection against hepatitis A can last upwards of 20 years. Common adverse side effects of Hepatitis A vaccination are drowsiness, loss of appetite, and fever. Caution must be taken if a previous dose of any hepatitis A-containing vaccine, including neomycin (aminoglycoside antibiotic) has been injected because this can lead to a severe allergic reaction (anaphylaxis). There is currently no specific treatment for hepatitis A.
Several vaccines are available for preventing hepatitis B. These vaccines rely on the use of one of the viral envelope proteins (hepatitis B surface antigen). The success rate is high, and immunity can last over 20 years. Infants can be vaccinated at birth. Available antiviral drugs, such as lamivudine, adefovir, tenofovir, telbivudine, entecavir and immune system modulators interferon alpha-2a, and PEGylated interferon alpha-2a, can stop the hepatitis B virus from replicating and thereby minimize liver damage. However, they cannot clear a hepatitis B infection. A liver transplant for end-stage chronic hepatitis B may be effective in overcoming the disease. Adverse side effects of liver transplantation include bleeding, infection, painful incision, possibility of blood clots, prolonged recovery, and death.
Hepatitis C produces chronic infection in 50-80% of infected people. Approximately 50% of chronically infected people do not respond to therapy. Current treatment techniques for hepatitis C include a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b and ribavirin for 24 or 48 weeks. If at least a 2-log viral load reduction does not occur after 12 weeks of treatment, the success rate in overcoming hepatitis C is less than 1%. Also, the treatment can be mentally and physically demanding and can sometimes cause temporary disability. A substantial fraction of treated persons experience adverse side effects ranging from flu-like symptoms to severe adverse effects such as anemia and cardiovascular complications. Due to the physiological rigors of the treatment, some infected people may attempt or consider suicide.
There are currently no successful treatments for chronic hepatitis D. In combination with the hepatitis B virus, hepatitis D has the highest mortality rate of all hepatitis infections.
Many people with hepatitis E experience a self-limited illness and go on to recover completely. However, there is currently no therapy or medicine effective against chronic hepatitis E. In many cases, hospitalization is recommended for the severely ill. Supportive care may be needed.
Herpesviruses or herpesviridae is a family of eight DNA viruses. The members of the family are herpes simplex virus 1 (“HSV-1”), herpes simplex virus 2 (“HSV-2”), varicella zoster virus (chicken pox and shingles), Epstein-Barr virus (infectious mononucleosis, Burkitt's lymphoma, central nervous system lymphoma in AIDS patients, post-transplant lymphoproliferative syndrome, nasopharyngeal carcinoma, and HIV-associated hairy leukoplakia), cytomegalovirus (infectious mononucleosis-like syndrome and retinitis), two roseoloviruses (roseola infantum and exanthem subitum), and Kaposi's sarcoma-associated herpes rhadinovirus (primary effusion lymphoma and types of multicentric Castleman's disease implicated as a cause of cancer in people with AIDS).
Herpes simplex infections, generally referred to as herpes simplex 1 and herpes simplex 2, are primarily oral and genital. They generally occur when HSV-1 or HSV-2 comes into contact with the oral mucosal tissue, abraded skin of the mouth, the face, or the genital area. Herpes simplex 1, predominantly orofacial, is usually acquired orally during childhood but may be sexually acquired. Herpes simplex 2, predominantly genital, is sexually transmitted in most cases. Herpes simplex 1 tends to be more common than herpes simplex 2. However, cases of oral infection by HSV-2 are increasing.
Herpes labialis, often referred to as cold sores, is a common type of herpes infection caused by HSV-1 or HSV-2. Cold sores, whether initial or recurring, are usually first felt as a tingling or itching sensation in the affected location. The initial feelings are normally followed, depending on the severity of the infection, by the emergence of a raised or swollen area on the skin. The blister or swollen area becomes generally painful but acutely sore when touched, stretched, or moved. In a few days to a few weeks, the sore area abscesses and emits a virus-laden clear fluid for several days before scabbing over. Once scabbed over, the lesion usually heals completely in a week to ten days. In immune-compromised people, this cycle may be significantly extended.
There is currently no cure or treatment to eradicate herpes simplex 1 or 2 from the body at activations of HSV-1 or HSV-2. An analgesic such as paracetamol can reduce pain and fever during outbreaks of herpes simplex 1 or 2 but has adverse side effects including hemolytic anemia, jaundice, leukopenia, neutropenia, pancytopenia, and thrombocytopenia. In addition, high-dose usage of paracetamol increases the risk of gastrointestinal complications such as stomach bleeding.
Topical docosanol, an antiviral agent, is used to treat the symptoms of HSV-1 and HSV-2 infections around the mouth. Docosanol may help relieve pain and moderately reduce the healing time (if any) of cold sores. There are conflicting reports on the efficacy of topical docosanol in actually helping herpes simplex infections to heal faster. A common adverse side effect of docosanol is headache.
There is currently no cure for any of the other six herpes viral infections. The herpes infection remains within its host cell in a dormant state and can reactivate at anytime to produce further conditions of the disease.
Herpes infections are typically treated with antiviral drugs, such as docosanol, that intervene with viral replication by providing an immune response, alleviating duration, frequency, and severity, and reducing chance of transmission to others. Other antiviral drugs for treating some herpes infections include acyclovir, ganciclovir, and valacyclovir. Acyclovir has low water solubility and therefore poor oral bioavailability, making intravenous administration necessary at high concentrations. Adverse side effects associated with systemic acyclovir include nausea, vomiting, diarrhea, headache, and, in large doses, hallucinations. Valaciclovir is a prodrug, an esterified version of acyclovir that has greater oral bioavailability than acyclovir. Valaciclovir has adverse side effects similar to those of acyclovir. Ganciclovir is correlated to a range of serious hematological adverse effects. The common adverse side effects of ganciclovir are anemia, fever, dyspepsia, anorexia, and seizures. Ganciclovir is considered a potential human carcinogen, mutagen, and teratogen.
The efforts of researchers in developing treatments for viral infections have been repeatedly frustrated by both the morphology and the metabolic nature of viruses. In brief, no efficient way for treating many viral diseases is currently available. There is a critical need for treatments which are effective and safe and display minimal adverse side effects.
An allergy is an abnormal, acquired sensitivity to a given substance, including pollen, drugs, or numerous environmental triggers through a local or systemic inflammatory response. Allergies are characterized by sneezing, runny nose, and itchy eyes. Allergic rhinitis, commonly known as “hay fever”, is an allergy particularly prevalent from late May to the end of June.
Antihistamines may relieve the symptoms of allergic rhinitis but can cause drowsiness. Corticosteroid nasal sprays such as fluticasone and mometasone furoate can be effective but have adverse side effects. See U.S. Pat. No. 6,723,713 B2 with regard to mometasone furoate.
Arthritis is a group of over 100 medical conditions involving damage to the joints of the body. Osteoarthritis (degenerative joint disease), the most common form of arthritis, is variously caused by trauma to a joint, infection of the joint, or aging. In osteoarthritis, wearing of the cartilage that covers and acts as a cushion inside the joint produces low-grade inflammation that results in pain in the joint. As the bone surfaces become less well protected by cartilage, joint pain is experienced during weight bearing, walking, and standing. Symptoms of osteoarthritis include acute pain in the bones and muscles, particularly neck and back pain, burning sensations in the associated muscles and tendons, swelling, tenderness, and muscle spasms.
Osteoarthritis is generally treated with NSAIDs and local injections of glucocorticoids. NSAIDs have the adverse side effects discussed above and further below. Glucocorticoids have the adverse side effects discussed below. In severe cases, joint replacement surgery is performed to alleviate osteoarthritis. Regeneration of cartilage has not yet been achieved. Accordingly, there is currently no full cure for osteoarthritis. However, osteoarthritis caused by cartilage damage, e.g., as a result of an injury, can sometimes be treated with autologous chondrocyte implantation. The adverse side effects of joint replacement surgery and autologous chondrocyte implantation include damage to blood vessels, dislocation, infection, instability, nerve damage, persistent pain, and weakness.
Gouty arthritis, or gout, is a congenital disorder involving uric acid metabolism. In gouty arthritis, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons, and surrounding tissues due to elevated concentrations of uric acid in the blood stream. This provokes an inflammatory reaction of these tissues. The deposited crystals often increase in size and burst through the skin to form sinuses, discharging a chalky white material. Symptoms of gouty arthritis include acute inflammatory arthritis (a red, tender, hot, swollen joint), pain in the affected joint subsequent to warmth, swelling, and tenderness.
Temporary relief to the pain and reduction of the inflammation swelling that occurs in gout may be achieved with NSAIDs such as ibuprofen. The adverse side effects of ibuprofen are discussed above and below. Intraarticular glucocorticoids, administered via joint injection, are reserved for more serious cases of gout. Adverse side effects of glucocorticoids include immunosuppression, hyperglycemia, hypertension, and proteolysis. Long term use of glucocorticoids impairs many health anabolic processes. Colchicine was once the drug of choice for acute attacks of gout. However, colchicine impairs the motility of granulocytes. Also, colchicine sometimes has adverse side effects such as gastrointestinal upset, including diarrhea and nausea.
Other forms of arthritis include rheumatoid arthritis, psioriatic arthritis, and septic arthritis. Rheumatoid arthritis is a chronic systemic inflammatory disorder which affects many tissues and organs, but mainly attacks the joints producing an inflammatory synovitis that often results in destruction of the articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera as well as nodular lesions.
Psoriatic arthritis is an inflammatory condition typically affecting people suffering from the chronic skin condition psoriasis. There are five main types of psoriatic arthritis: symmetric psoriatic arthritis (affecting joints on both sides of the body), asymmetric psoriatic arthritis (typically involving less than three joints), spondylitis (stiffness of the spine, neck, hands or/and feet), arthritis mutilans (which can cause severe joint damage), and distal interphalangeal predominant psoriatic arthritis (inflammation and stiffness in the joints at the end of the fingers and toes). A large number of patients with psoriatic arthritis have fingernail deformities and, in severe cases, onycholysis (loss of nails). Psoriatic arthritis can also cause dactylitis and tendinitis.
Septic arthritis is caused by bacterial, mycobacterial, fungal, and viral joint infections. Bacteria commonly found to cause septic arthritis are staphylococcus aureus and streptococcus. Symptoms of septic arthritis include fever, intense joint pain, joint swelling, and pseudoparalysis. 
As indicated above in connection with osteoarthritis and gouty arthritis, many techniques and medicines have been developed to treat the various types of arthritis. Unfortunately, treatment success is often slow and achieved only partially or not at all.
Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. The symptoms of bronchitis include expectorating cough, shortness of breath (dyspnea), wheezing, occasionally chest pains, fever, and fatigue or malaise. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks. Acute bronchitis, which is characterized by cough and phlegm (sputum) production and symptoms, is related to the obstruction of the airways by the inflammation and phlegm. Chronic bronchitis, which may arise from sources other than infection, is generally part of chronic obstructive pulmonary disease. Chronic bronchitis is characterized by persistent cough which produces phlegm.
Antibiotics are commonly used to treat bronchitis if a bacterial infection is suspected. The adverse side effects of antibiotics have been mentioned above. A bronchodilator, such as salbutamol, can be used to treat bronchitis but has adverse side effects including dry mouth, fine tremor, headache, muscle cramps, and palpitation.
Dry coughs caused by bronchitis are commonly treated with cough suppressants that suppress the body's urge to cough. Centrally acting cough suppressants, such as codeine and dextromethorphan, reduce the urge to cough by inhibiting the response of the sensory endings by depolarization of the vagus nerve. Adverse side effects associated with the use of codeine include itching, nausea, vomiting, drowsiness, urinary retention, and constipation. Dextromethorphan, when taken at higher than physician-recommended doses, is classified as a dissociative hallucinogenic drug. Because dextromethorphan can trigger a histamine release, use of dextromethorphan in atopic children is very limited. Productive coughs are treated with expectorants that loosen mucus from the respiratory tract. Guaifenesin, an expectorant drug commonly used for productive coughs, is generally effective but can cause adverse side effects including nausea, vomiting, and occasionally the formation of kidney stones of uric acid.
Hemorrhoids are varicosities or swelling and inflammation of rectal and anal veins. Both constipation and chronic diarrhea, which increase straining during bowel movements, can lead to hemorrhoids. Postponing bowel movements and fiber-deprived diet both lead to constipation and thus can cause hemorrhoids. Hemorrhoid symptoms include hematochezia (stool with blood), rectal and anal itching, pain, and swelling. For many people, hemorrhoids are mild and temporary conditions which heal spontaneously or by the same measures recommended for prevention.
No medicine is currently available for curing hemorrhoids. However, local treatments such as cold compresses, topical analgesics, and topical corticosteroids can provide temporary relief. Consistent use of topical analgesics during the early stages of a hemorrhoid flare-up can provide relief and stave off further development and irritation. However, topical analgesics such as dibucaine may cause allergic reactions including hives and swelling of the face, lips, tongue, and throat. Topical corticosteroids, such as hydrocortisone which contain steroid preparations, may weaken the skin and contribute to further flare-ups.
Urticaria, or hives, is a skin condition characterized by raised red skin welts. The welts can appear anywhere on the body, including the face, lips, tongue, throat, and ears. The welts typically itch severely, sting, and/or burn and often have a pale border. Urticaria is generally caused by direct contact with an allergenic substance or an immune response to food or some other allergen but can appear for other reasons.
Urticaria can be very difficult to treat. Most treatment plans involve being aware of what triggers urticaria. This can be problemsome because there are several different types of urticaria and people often exhibit more than one type. Also, symptoms are often idiopathic. Consequently, there might not be any clear trigger. If the triggers can be identified, then outbreaks can often be managed by limiting exposure to those triggers.
Drug treatment for urticaria is typically in the form of antihistamines. These are taken on a regular basis to produce a protective effect by lessening or halting attacks. For some people, antihistamines such as cimetidine and ranitidine may also help control symptoms either protectively or by lessening symptoms when an attack occurs. The use of cimetidine and ranitidine for urticaria is considered an off-label use because these two drugs are primarily used for the treatment of peptic ulcer disease and gastroesophageal reflux disease.
For very severe outbreaks, an oral corticosteroid such as prednisone is sometimes prescribed to treat urticaria. However this form of treatment is controversial due to the extensive adverse side effects common with corticosteroids and, as such, is not recommended as a long-term treatment option. None of these preceding urticaria treatments is a surefire means of controlling attacks. Some attacks seem to be treatment resistant. Medications can suddenly cease being as effective as they initially were.
A toothache is an aching pain in or around a tooth. Toothaches are generally caused by problems in the tooth or jaw, such as cavities, gum disease, the emergence of wisdom teeth, a cracked tooth, jaw disease, or/and or exposed tooth root. The causes of a toothache can also be a symptom of heart disease, such as angina or a myocardial infarction, due to referred pain. After having one or more teeth extracted, a condition known as dry socket can develop, leading to extreme pain.
Various analgesics, such as the over-the counter NSAID ibuprofen, can be effectively used to treat toothache pain. However, many of these analgesics have addictive and otherwise adverse side effects. For example, ibuprofen has been implicated in elevating cardiovascular risk such as myocardial infarction, particularly among persons chronically using high doses of ibuprofen. Other adverse side effects of ibuprofen use include nausea, gastrointestinal ulceration/bleeding, diarrhea, constipation, and hypertension.
Another drug commonly used for toothache pain is hydrocodone whose adverse side effects are varied and abundant. The main adverse side effects of hydrocodone use are respiratory effects which are very serious and commonly require the assistance of a physician. Hydrocodone can be habit forming, thereby leading to physical and psychological dependence on the drug. Other common adverse side effects of hydrocodone include nausea, sweating, constipation, vomiting, and euphoria.
Tinea pedis, commonly known as athlete's foot, is a parasitic fungal infection of the epidermis of the foot. Tinea pedis is typically caused by a mold, sometimes a yeast, which grows on the surface of the skin and then grows into the living skin tissue itself to produce the infection. The symptoms of tinea pedis include scaling, flaking, and itching of the affected skin. Blisters and cracked skin may also occur, leading to exposed raw tissue, pain, and swelling.
Tinea pedis is often treated with topical antifungal agents such as miconazole, ketaconazole, sertaconazole, or/and a keratolytic such as salicylic acid. These topical agents only clear the infection approximately 30% of the time and provide mycologic cures (absence of organisms) less than 15% of the time. The time for curing tinea pedis is typically long, often 45 days or more.
Acute viral nasopharyngitis, often known as the common cold, is an infectious viral disease of the upper respiratory system. Symptoms include sneezing, runny nose, nasal congestion, sore and phlegmy throat, coughing, headache, and tiredness. Acute viral nasopharyngitis is caused by rhinoviruses, corona viruses, human parainfluenza viruses, human respiratory syncytial viruses, adenoviruses, enteroviruses, metapneumovirus, and influenza viruses. In total, over 200 serologically different viral types cause acute viral nasopharyngitis.
There is currently no known cure for acute viral nasopharyngitis. Due to the many different types of viruses that cause acute viral nasopharyngitis and their tendency for continuous mutation, it is essentially impossible to gain complete immunity to acute viral nasopharyngitis. Treatment is limited to symptomatic supportive options, maximizing the comfort of the patient, and limiting complications and harmful sequelae.
Acute viral nasopharyngitis is self-limited. The host's immune system effectively deals with the infection. Within a few days after onset of acute viral nasopharyngitis, the body's humoral immune response begins producing specific antibodies for preventing the virus from infecting cells. Additionally, as part of the cell-mediated immune response, leukocytes destroy the particular virus through phagocytosis and infected cells to prevent further viral replication. In healthy immunocompetent people, the common cold goes away in seven days on average. An infected person often feels listless during the resolution period.
Dandruff is a medical condition that arises from excessive shedding of dead skin cells from the scalp. Some people, either chronically or as a result of certain triggers, experience an unusually large amount of skin flaking This may be accompanied by burning, redness, itching, and irritation of the scalp. The fungus malassezia furfur, found naturally on the skin surface of both healthy people and those with dandruff, has been cited as a cause of dandruff. However, it has recently been shown that a scalp specific fungus, malassezia globosa, may cause dandruff.
There are many treatments for dandruff. The most popular are topical zinc pyrithione, ketoconazole, and selenium sulfide. Although these treatments reduce the symptoms of dandruff, they do not eliminate it.
An itch is a sensation felt on an area of skin which causes a person to scratch the area. Itching can be related to anything from dry skin to cancer. The main chemical involved in itching is histamine, a molecule released by mast cells in the skin. Histamine causes itch and reddening as a result of insect bites.
A variety of anti-itch drugs, such as synthetic cortisol, are available to treat itching. Cortisol, a vital corticosteroid hormone produced by the adrenal cortex, is often referred to as the “stress hormone” because it is involved in the response to stress. The synthetic form of cortisol, termed hydrocortisone, can increase blood pressure and blood sugar levels and has an immunosuppressive action. Local anesthetics, such as benzocaine, can be used as anti-pruritics for treating itches but can cause allergic reactions including skin rash, hives, and swelling of the face, lips, or/and tongue.
Bromhidrosis, or body odor, is the smell of bacteria growing on the body. The bacteria multiply considerably in the presence of sweat. However, sweat itself is almost odorless. Bromhidrosis is associated with hair, feet, skin in general, armpits, genitals, and mouth. While bromhidrosis is sometimes believed to be the result of poor personal hygiene, bromhidrosis can be caused by changes in diet. Treatments for bromhidrosis include deodorants and perfumes which mask the smell but do not eliminate the odor.
Vaginitis, a common problem for women, is an inflammation of the vaginal mucosa and is often associated with an irritation or infection of the vulva leading to vulvovaginitis. Vaginitis may be asymptomatic, but usually leads to significant vaginal itching and irritation so that an infected woman self-medicates or seeks professional help. The woman may have inflammation, itching, burning, and swelling caused by the presence of extra immune cells and may notice a discharge. Vaginitis caused by infections includes bacterium (gardnerella), parasitic protozoan (trichomoniasis), and yeast (candidiasis). Vaginitis infections can progress through the uterus into the fallopian tubes and ovaries and lead to infertility.
Treatments for vaginitis include antibiotics and antifungal creams depending on the causative agent. Antibiotics such as metronidazole can effectively treat vaginitis caused by gardnerella and trichomoniasis. However, metronidazole has the above-mentioned adverse side effects. Antifungal creams including fluconazole can effectively treat vaginitis caused by candidiasis but may have adverse side effects such as abdominal pain, diarrhea, nausea, rash, and elevated liver enzymes. A cream containing cortisone can be used to relieve some of the irritation of vaginitis. If an allergic reaction arises with the use of cortisone, an antihistamine may be prescribed. Common adverse side effects of antihistamines are sedation, tinnitus, tremor, nausea, and vomiting.
Cancer is a class of diseases in which a group of cells display uncontrolled growth and intrusion, destruction of adjacent tissues, and metastasis. These three malignant properties of cancers differentiate from benign tumors, which are self-limited, and do not invade or metastasize. Most cancers form tumors.
Cancer often explodes in something akin to a chain reaction caused by a few errors, which compound into more severe errors. Errors which produce more errors are effectively the root cause of cancer, and also the reason that cancer is so difficult to treat. Even if the vast majority, typically millions, of cancerous cells can be effectively killed, the few remaining cancerous cells (and other error-prone precancerous cells) can self-replicate or send error-causing signals to other cells, thereby restarting the cancerous process.
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens such as tobacco smoke, radiation, certain chemicals, and infectious agents. Other cancer-promoting genetic abnormalities can be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth.
Cancers caused by infection originate from viral pathogens. The main viruses associated with cancers are human papillomavirus, hepatitis B and hepatitis C virus, Epstein-Barr virus, and human T-lymphotropic virus. Liver cirrhosis, whether from chronic viral hepatitis infection or alcoholism, is associated with the development of liver cancer. The combination of cirrhosis and viral hepatitis presents the highest risk of liver cancer development. Worldwide, liver cancer is one of the most common, and most deadly, cancers due to a huge burden of viral hepatitis transmission and disease.
Common forms of cancer include carcinoma, sarcoma, leukemia, lymphoma, germ cell tumors, and blastic tumors. Carcinoma is a malignant tumor derived from epithelial including breast, prostate, lung, and colon cancer. Sarcoma includes malignant tumors derived from connective tissue or mesenchymal cells. Leukemia and lymphoma malignancies are derived from hematopoietic cells. Germ cell tumors are derived from totipotent cells. A blastic tumor or blastoma is usually a malignant tumor resembling an immature or embryonic tissue.
The symptoms of cancer can be divided into (1) local symptoms including unusual lumps or swelling (tumor), hemorrhage, pain and ulceration, and compression of surrounding tissues that can cause yellowing of the eyes and skin, (2) metastasis symptoms including enlarged lymph nodes, cough and hemoptysis, hepatomegaly, fracture of affected bones, and neurological symptoms, and (3) systemic symptoms, including weight loss, fatigue and cachexia, excessive sweating, anemia, and specific paraneoplastic phenomena.
Complete removal of the cancer without damage to the rest of the body is the goal of treatment. This can sometimes be accomplished by surgery, chemotherapy, radiation therapy, and/or cancer immunotherapy. The propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits the effectiveness of surgery. The effectiveness of chemotherapy using anti-cancer drugs to destroy cancerous cells is often limited by toxicity to other tissues in the body, especially those tissues that have a high replacement rate, such as the intestinal lining. As to radiation therapy, the radiation dose to each cancerous site depends on a number of factors, including the radiosensitivity of each cancer type and whether there are tissues and organs nearby that can be damaged by radiation. Radiation therapy is thus not without adverse side effects to normal healthy tissues. In cancer immunotherapy, antibodies targeted to disease-causing antigens can be effective under certain circumstances. However, their efficacy may be limited by other factors. For instance, the microenvironment is immunosuppressive in the case of cancer tumors, thereby allowing even those tumors that present unusual antigens to survive and flourish in spite of the immune response generated by the cancer patient against his or her own tumor tissue.
Angiogenesis inhibitors prevent the extensive growth of blood vessels that tumors require to survive. Angiogenesis inhibitors, such as bevacizumab, have been approved and are in clinical use. One main problem with anti-angiogenesis drugs is that many factors stimulate blood vessel growth in normal or cancerous cells. Anti-angiogenesis drugs typically target the vascular endothelial growth factor pathway while other factors can continue blood vessel growth, e.g., vasculogenesis. Other problems include route of administration, maintenance of stability and activity, and targeting at the tumor vasculature.
Heart conditions and diseases constitute a spectrum of conditions that variously affect the heart, including the coronary blood vessels, in a debilitating manner. Major heart diseases and conditions include arrhythmias, cardiomyopathies, cardiovascular diseases, congenital heart defects, heart infections, and valvular heart diseases.
Arrhythmia, also known as cardiac dysrhythmia, is group of conditions in which the heart beat is abnormal due to abnormal electrical activity in the heart. The heart may beat too fast, too slow, or/and irregularly. Causes of arrhythmias include congenital heart defects, coronary artery disease, deformity of the heart, diabetes, excessive alcohol or caffeine use, hypertension, illicit substances, tobacco smoking, stress, and valvular heart disease. Symptoms of arrhythmias include chest pain, dizziness, fainting, shortness of breath, bradycardia, and tachycardia.
Medications to treat arrhythmias include antiarrhythmics, such as quinidine, and beta blockers, such as nebivolol. Quinidine can cause adverse side effects including granulomatous hepatitis, myasthenia gravis, thrombocytopenia, and torsades de pointes. Nebivolol can cause adverse side effects including bradycardia, depression, fatigue, and impotence.
Pacemakers or implantable cardioverter-defibrillators can be surgically implanted inside the body to emit electrical impulses for regulating the heartbeat. Complications of pacemaker surgery include abnormal heart rhythms, bleeding, and infection. Open-heart surgery to ameliorate arrhythmias may require many months for recovery. Also, adverse side effects of open-heart surgery include abnormal scar formations, atrial fibrillation, graft failure, myocardial infarction, serious bleeding, stroke, and artery, kidney, lung, and other organ problems. Although open-heart surgery can improve the quality of life, open-heart surgery can be complex, risky, and destructive due to its invasive nature, and is commonly considered a last treatment option.
Cardiomyopathy is a thickening, enlarging, and stiffening of the heart muscles. Symptoms of cardiomyopathy include bloating, breathlessness even at rest, fatigue, fainting, irregular heartbeats, and swelling of the legs, ankles, and feet. There are three forms of cardiomyopathy: dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy. Dilated cardiomyopathy is generally the most common. In dilated cardiomyopathy, the heart's main pumping chamber, namely the left ventricle, becomes dilated. The pumping capability becomes inadequate for blood to flow to the heart. Hypertrophic cardiomyopathy involves abnormal growth or thickening of the heart and particularly affects the left ventricle. When thickening occurs in hypertrophic cardiomyopathy, the heart may stiffen. The area of the left ventricle may condense and thereby interfere with the heart's capability to deliver blood to the body. Restrictive cardiomyopathy occurs when the heart becomes stiff and less elastic. The heart ceases being able to properly expand and fill with blood between heartbeats. The specific causes of cardiomyopathies are not currently known.
Various treatments are available for cardiomyopathies. Medications include angiotensin II receptor antagonists, such as olmesartan, but have adverse side effects including diarrhea, dizziness, flu-like symptoms, headache, hyperglycemia, tachycardia, and upper respiratory tract infection. Angiotensin converting enzyme inhibitors such as enalapril can also be used. However, they have adverse side effects including cough, diarrhea, dizziness, electrolyte disorders, and vomiting, and can lead to very low blood pressure. Enalapril can inflict serious harm to a fetus if taken during pregnancy. Beta blockers such as nebivolol can be used but have adverse side effects including bradycardia, depression, fatigue, and impotence.
For dilated cardiomyopathy, pacemakers or implantable cardioverter-defibrillators can be implanted inside the body. Again, the complications of pacemaker surgery include abnormal heart rhythms, bleeding, and infection. A heart transplant can be performed for a severe cardiomyopathy. Adverse side effects of heart transplantation include bone loss, infections, ulcers, long recovery time, rejection of the donor heart, and possibly reduced life expectancy. A heart transplant is one of the most risky operations and should only be considered if other available treatments are unlikely to be successful.
Cardiovascular diseases arise when the blood vessels are narrow or blocked. The circulation of blood to the heart, brain, and other parts of the body becomes inadequate. Coronary heart diseases and ischaemic heart diseases are general forms of cardiovascular diseases. Atherosclerosis is a common cardiovascular disease that affects the arteries and can lead to coronary artery disease and peripheral artery disease. Symptoms of cardiovascular disease include angina, coldness, pain, shortness of breath, weakness, myocardial infarction, heart failure, stroke, and sudden cardiac death.
Medications for cardiovascular diseases include angiotensin converting enzyme inhibitors such as enalapril. Beta blockers such as nebivolol can also be used. The adverse side effects of enalapril and nebivolol have been mentioned above. Statins, including simvastatin, are commonly effective but have adverse side effects including headache, abdominal pain, constipation, diarrhea, weakness, chest pain, peripheral edema, and active liver diseases (hepatic encephalopathy). Simvastatin can cause harm to fetal development in nursing mothers.
Surgery for cardiovascular diseases includes coronary angioplasty and coronary artery bypass surgery. Coronary angioplasty involves placing a tube in a blocked artery, threading a balloon to the blocked artery, and inflating the balloon to reopen the artery. Serious risks of coronary angioplasty include aortic dissection, myocardial infarction, and stroke. Coronary artery bypass surgery involves removing the blocked portion of the artery and taking a vein from another part of the body to replace the diseased part of the artery. Adverse side effects of coronary artery bypass surgery include anesthetic complications, malignant hyperthermia, acute renal failure, chronic pain, chronic stress, hypoperfusion, keloid scarring, myocardial infarction, nonunion of the sternum, stenosis, and stroke.
Congenital heart defects typically develop while the baby is still inside the womb. The symptoms of congenital heart defects include cyanosis, shortness of breath during exercise, and swelling in the abdomen, feet, legs, and hands and around the eyes. The causes of congenital heart defects are not well understood. Genetics, medical conditions, and medications can be contributing factors of congenital heart defects.
Treatments for congenital heart defects include catheterization techniques, typically performed by inserting a catheter into a leg vein and guiding it to the heart with the assistance of radiology images. When the catheter is positioned at the site of the defect, tools are threaded through the catheter to the heart to repair the defect. Potential complications of a catheter include bleeding, blood clots, cardiac arrhythmias, cardiac tamponade, damage to the kidneys, hematoma, low blood pressure, and pain. One or more open-heart surgeries may be needed to fully correct the defect. The disadvantages of open-heart surgery have been mentioned above. An extreme option is a heart transplant, again a highly risky procedure.
Heart infections can be caused by inflammation, bacteria (streptococcus pyogenes which can lead to rheumatic fever, streptococcus pneumoniae, and brucella), viruses (adenovirus, coxsackie virus B, echovirus, Epstein-Barr virus, parvovirus B19, rubella virus, and sexually transmitted viruses), fungi (candida albicans, aspergillus, and coccidioides), and parasites (trypanosoma cruzi and toxoplasma). Some medications including antibiotics, such as penicillin and sulfonamide drugs, and illicit substances can cause heart infections. Other diseases that can cause heart infections include connective tissue disorders, lupus, vasculitis, and Wegener's granulomatosis.
Three common types of heart infections are endocarditis, myocarditis, and pericarditis. Endocarditis induces the inner membrane that apportions the chambers and valves of the heart (endocardium). Myocarditis induces the muscular median layer of the walls of the heart (myocardium). Pericarditis induces the tissue surrounding the heart (pericardium). Symptoms of heart infections include angina, coughing, fever, fatigue, rashes, shortness of breath, somnolence, swelling, syncope, heart palpitations, and myocardial infarction. Treatments for heart infections include antibiotics, angiotensin converting enzyme inhibitors, and beta blockers. All of these treatments can be effective. However, they have the above-mentioned adverse side effects and other disadvantages.
Valvular heart diseases involving the aortic, mitral, pulmonary, and tricuspid valves which open and close for directing blood flow through the heart can arise for many reasons including being born with the condition, connective tissue disorders, hereditary, high blood cholesterol levels, hypertension, increased age, inadequate hygiene, obesity, stress, tobacco smoking, infections, rheumatic fever, radiation treatments for cancer, and certain medications. Symptoms of valvular heart disease include chest pain, fatigue, fainting, heart murmur, irregular heartbeat, leaking, prolapse, shortness of breath, stenosis, and swollen feet or ankles
Treatments for valvular heart disease vary depending on which valve is affected. Treatment options include medications and surgery. Medications include vasodilators such as adenosine, anticoagulants such as warfarin, and diuretics such as acetazolamide. Adverse side effects of adenosine include, allergic reactions, chest pain or pressure, dizziness, flushing of the face, headache, high blood pressure, tingling in the arms, and throat, neck, and jaw discomfort. Warfarin is contraindicated in pregnancy and can cause bleeding in the fetus, preterm birth, spontaneous abortion, stillbirth, and neonatal death. A common adverse side effect of warfarin is hemorrhage. A rare adverse side effect of warfarin is necrosis. Adverse side effects of acetazolamide include frequent urination, headaches, numbness and tingling in the fingers and toes, metabolic acidosis, parageusia, and increased risk of developing calcium oxalate and calcium phosphate kidney stone.
There are two main types for surgery involving the mitral valve, namely repair and replacement. Mitral valve repair typically consists of annuloplasty or valvuloplasty surgery that can preserve the valve Annuloplasty involves repairing the mitral valve by reconnecting valve leaflets or by abstracting surplus valve tissue, making the leaflets able to close tightly. Valvuloplasty consists of correcting the mitral valve to eliminate inverted blood flow.
Valvular valve replacement surgery involves replacing a damaged mitral valve with a prosthetic mechanical or tissue valve. Mechanical valves generally have a long shelf life. However, an anticoagulant medication such as warfarin may need to be used for the remainder of the person's life to prevent blood clots from forming on the valve. If a blood clot forms on the valve and disengages, the blood clot can travel to the brain and induce a stroke. Tissue valves are provided from an animal's tissue such as a pig's heart valve. While tissue valves generally do not last as long as mechanical valves, a long term anticoagulant medication may not be necessary with a tissue valve. Increased risks for anesthesia used in mitral valve surgery include arrhythmia, malignant hyperthermia, and seizures. Valve repair and replacement surgery requires open heart surgery and significant recovery time. Complications from valvular surgery include allergic reaction, bleeding, chronic pain, infection, keloid formation, myocardial infarction, and stroke.
Hypercholesterolemia, a lipid disorder, is a condition in which the blood has a high level of cholesterol. Closely related to hypercholesterolemia is hypertriglyceridemia, another lipid disorder in which excess triglycerides are present in the blood plasma. Hypercholesterolemia and hypertriglyceridemia arise when the blood contains excessive fatty substances. Abnormally high cholesterol and triglyceride levels can be caused by obesity, diet, metabolic syndromes, excessive alcohol consumption, family history, and certain medications, including birth control pills, beta blockers, certain antidepressants, and certain diuretics.
A lipid disorder increases risk of hypothyroidism, polycystic ovary syndrome, and kidney diseases. Lipid disorders also increase the risk of atherosclerosis and thus the risk of heart disease, myocardial infarction, stroke, and hypertension (high blood pressure). In leading to atherosclerosis, hypercholesterolemia can specifically lead to arrhythmias, arterioles, bacterial endocarditis, cardiomyopathy, cerebrovascular accident, cerebrovascular disease, coronary artery disease, Kawasaki disease, diseases of pulmonary circulation, diseases of veins and lymphatics, and other diseases of the circulatory system.
Atherosclerosis arises when an artery wall thickens due to the build-up of cholesterol, fat, or/and other substances on the artery wall. The build-up can harden and form plaque, making the artery narrow. Eventually it becomes difficult for blood to flow through the artery. The blood can clot, i.e., undergo thrombus. When thrombus occurs in the heart, angina, shortness of breath, and myocardial infarction can occur. If thrombus occurs in the brain, a stroke can occur. Thrombus in the limbs can result in claudication (impairment in walking) Because atherosclerosis can be systemic, other undesirable medical conditions can occur in the intestines, kidneys, and lungs. In addition to the causative factors mentioned above for abnormally high cholesterol and triglyceride levels, atherosclerosis can arise from diabetes, high blood pressure, increasing age, and tobacco smoking
The first line of treatment for atherosclerosisis is preferably exercising and a well balanced diet with plenty of fiber-rich fruits and vegetables and avoidance of saturated fats and trans-fatty acids. Medications to treat atherosclerosis include statins, such as simvastatin and clopidogrel, to treat plaque and lower cholesterol. Simvastatin has the adverse side effects mentioned above. Clopidogrel, a oral antiplatelet agent, can inhibit thrombus but has the adverse side effects of hemorrhage, neutropenia, abdominal pain, chest pain, and headache.
Diabetes mellitus is a chronic disease in which there is a high level of glucose, or sugar, in the blood. Insulin is a hormone produced by the pancreas to manage glucose and is required to move glucose from the bloodstream into liver cells, muscles, and fat so that the glucose can be used as fuel to provide energy for the body. Diabetes mellitus generally arises when the pancreas does not manufacture enough insulin or/and liver cells, muscles, and fat do not respond properly to insulin.
Diabetes mellitus can harm blood vessels and nerves. As a result, individuals with diabetes mellitus commonly have foot problems. In severe, circumstances an affected foot may need to be amputated. Diabetes is one of the most common causes of amputations.
The three major forms of diabetes mellitus are diabetes type 1, diabetes type 2, and gestational diabetes. Diabetes type 1 is usually identified during childhood but can be identified in persons over 20 years old. While the precise cause of diabetes type 1 is relatively unknown, diabetes type 1 can arise due to genetics, autoimmune conditions, or/and viruses. Diabetes type 2 is more common than diabetes type 1 and typically occurs in adults. Gestational diabetes is high blood glucose that can develop in a woman during pregnancy. Other forms of diabetes mellitus include congenital diabetes, cystic fibrosis-related diabetes, steroid diabetes, and forms of monogenic diabetes.
Diabetes mellitus is debilitating and can cause numerous adverse medical conditions including atherosclerosis, blindness, cardiovascular diseases, chronic renal failure, congenital cardiac disease, chronic pancreatitis, coronary artery disease, Cushing's syndrome, diabetic dermadromes, elevated cholesterol levels, erection problems, fatty liver, Friedreich's ataxia, haemochromatosis type 1, heart diseases, hyperlipidemia, hypoglycemia, kidney failure, metabolic disorders, myotonic dystrophy, peripheral vascular diseases, retinal damage, ulcers, several mitochondrial neuropathies, and myopathies. Individuals with diabetes mellitus can suddenly undergo a severe attack such as diabetic ketoacidosis in which there is an absolute shortage of insulin. Another severe condition is nonketotic hyperosmolar coma in which the body is dehydrated due to loss of body water. Acute or prolonged hypoglycemia, arising, for example, from diabetes mellitus, can lead to brain damage, paralysis, or death.
There is currently no effective cure for diabetes mellitus. Prevention involves maintaining a healthy low-fat diet and exercise to balance the sugar level in blood, blood pressure, and cholesterol. Medications to treat diabetes include insulin to assist in lowering the glucose level.
There are various difficulties with insulin for treatment of diabetes mellitus including the mode of administration, selecting the correct dosage, timing of the dosage, and variability in absorption. If too much or too little insulin is delivered, hyperglycemia can be induced. Adverse side effects of insulin reaction include convulsions, confusion, headache, unconsciousness, and weakness. If the use of insulin results in the body cells not absorbing blood glucose, a hypoglycemic coma can occur.
Ocular conditions consist of irritations and infections of the visual pathways including the eyes and eyelids. Some eye problems are minor and transient. Others can lead to loss of vision. Common eye problems include conjunctivitis, trachoma, and uveitis.
Conjunctivitis (pink eye) is inflammation or infection of the membrane lining the conjunctiva (eyelids). Symptoms of conjunctivitis include blurred vision, chemosis (irritation), epiphora (watering), hyperaemia (redness), and pain. Individuals with conjunctivitis frequently have difficulty opening their eyes after sleeping for extended periods due to dried crusts or mucus on the eyelids. Conjunctivitis can be caused by allergenic (hay fever), bacterial (chlamydia trachomatis or moraxella), chemical and related irritant (fumes, pet hairs, and use of contact lenses), and viral (adenovirus) conditions.
There are a number of types of conjunctivitis, each with its own treatment. Allergenic conjunctivitis is treated with antihistamines and NSAIDs which have the above-mentioned adverse side effects. Bacterial conjunctivitis can be treated with antibiotic eye drops. The adverse side effects of such treatment range from fever and nausea to major allergic reactions. There is currently no specific treatment for viral conjunctivitis. Cold compress and artificial tears may provide symptomatic relief for viral conjunctivitis. Moderate conjunctivitis due to chemicals and irritants can be treated effectively with saline solution. However, major chemical burns of the eyes can lead to severe eye problems.
Trachoma is an infectious eye disease, generally caused by the bacteria chlamydia trachomatis and is spread by individuals, inanimate objects, and flies. Trachoma symptoms include cloudy cornea, corneal scarring, eye discharge, swollen eyelids, swelling of lymph nodes in front of the ears, and trichiasis in which the eyelashes are turned in. Trichiasis can result in eye ulcers, additional scarring, vision loss, and possibly blindness.
Techniques to avoid trachoma include keeping the face and environment clean. Trachoma can be effectively treated with antibiotics, such as erythromycin and doxycycline, if applied sufficiently early, e.g., before the development of scarring and lid deformities. The adverse side effects of antibiotics have been mentioned above. Antibiotics should not be used in pregnant and nursing women due to potential damage to the fetus and child.
Uveitis is an inflammation of the interior of the eye. Uveitis can be categorized anatomically into anterior, intermediate, posterior, and panuveitic forms based on which part of the eye is affected by the inflammation. The symptoms of uveitis include dark floating spots in vision, eye pain, redness of the eyes, and sensitivity to light (photophobia). Serious complications include band keratopathy, cataracts, glaucoma, retinal edema, retinal detachment, and vision loss.
Uveitis is typically treated with corticosteroids administered orally or as eye drops. High doses of corticosteroids, e.g., 100 mg per day, must be used to treat severe and acute posterior uveitis. Such doses can cause severe complications. Thus, the administered amounts need to be reduced when clinical improvement occurs. However, reduction below 15-20 mg per day can lead to reoccurrences of the disease. In addition, corticosteroids have a number of adverse side effects as mentioned above.
The human ear consists of three parts referred to as the outer, middle, and inner ears. The outer ear, including the ear canal, collects sound waves. The middle ear, which is separated from the outer ear by the eardrum, amplifies the sound waves. The inner ear converts the amplified sound waves into electrical impulses that are sent to the brain. An array of conditions affect the hearing or/and balance of the body. Ear problems include Ménière's disease, tinnitus, and infections including otitis media, a common illness in infants and children.
Ménière's disease is an inner ear disorder that disturbs hearing and balance. The specific cause of Ménière's disease is not currently known. Ménière's disease affects the labyrinth in the inner ear. The labyrinth is a system of tiny channels filled with endolymph (fluid). Ménière's disease causes the endolymph to build up, disrupting both hearing and balance. Increase of the endolymph can cause the membranous labyrinth to dilate and lead to endolymphatic hydrops. Symptoms of Ménière's disease include vertigo, hearing loss, tinnitus, sensation of fullness, or/and pressure in ears. Ménière's disease can cause migraines to escalate.
There is currently no cure for Ménière's disease. Treatments for Ménière's disease include lipoflavonoid, the meniett device, and surgery. Lipoflavonid can sometimes help but is not approved by the U.S. Food and Drug Administration and can cause hives, upset stomach, and headaches. The meniett device provides transtympanic micropressure pulses that can reduce the frequency of vertigo but are not suitable for individuals with acoustic neuroma or brain tumor, erilymph fistula, etrocochlear damage, and low-pressure hydrocephalus. Surgery for treating Ménière's disease can consist of chemical labyrinthectomy in which an antibiotic (gentamicin) is injected into the inner ear for eradicating the vestibular apparatus. Alternatively, vestibular neurectomy surgery can be performed by sectioning the nerve of balance where it comes out of the brain while preserving the hearing portion of the nerve of balance. These types of surgery can eliminate vertigo but are destructive and are generally limited to individuals affected in one ear with Ménière's disease.
Tinnitus is the perception of sound within the ear in the absence of corresponding external sound. The causes of tinnitus are numerous and include excessive loud noises, aging, ear infections, genetics, and hundreds of medications such as analgesics, NSAIDs, and antibiotics. In many other cases, the specific cause of tinnitus cannot be established. Tinnitus is usually described as ringing or/and screaming sounds. Persons having tinnitus may have trouble hearing along with loss of concentration and loss of sleep.
If tinnitus is moderate, physical movements of the head, jaw, shoulder, tongue, and eyes can reduce the symptoms. Tinnitus can be treated with benzodiazepines such as clonazapam and lorazepam. Benzodiazepines have many adverse side effects including drowsiness, addiction, depression, euphoria, libido, and erection problems. Benzodiazepines taken during pregnancy can have adverse effects on the baby. Sudden withdrawal of benzodiazepines in pregnant women can result in spontaneous abortions.
Otitis media is an inflammatory infection of the middle ear. Otitis media infection can be caused by bacterial (haemophilus influenzae, Moraxella catarrhalis, and streptococcus pneumoniae), fungal (aspergillus and candida), and viral (respiratory syncytial virus) pathogens. When otitis media occurs, pressure builds up behind the tympanic membrane (eardrum) causing pain, and the middle ear becomes clogged with fluid and mucus. Symptoms of otitis media include Eustachian tube dysfunction, exudative inflammation, fever, meningism, severe pain, muffled noise in ear, deafness, and sensitive mastoid process.
Otitis media can be treated with analgesics such as ibuprofen, topical agents such as antipyrine and benzocaine ear drops, antibiotics such as amoxicillin, and surgery. Ibuprofen has the adverse side effects mentioned above. Antipyrine and benzocaine ear drops can cause adverse side effects such as itching, rash, and swelling of the mouth, face, lips, or/and tongue. Amoxicillin has various adverse side effects including allergic reactions and diarrhea. In chronic cases or with effusions, surgery can be performed by inserting a tympanostomy tube into the eardrum. This allows air to pass through and discharges pressure and excess fluids. The adverse affects of such surgery include a permanent hole in the eardrum, damage to the outer ear, ongoing fluid discharge from ear, scarring of the eardrum, and possible hearing loss.
The urethra is a tube which bridges the urinary bladder and allows the release of urine and other substances. The external urethral sphincter is a muscle that conducts the voluntary control of urination. Urethral disorders include urethral stricture and urethritis.
Urethral stricture is an abnormal narrowing of the opening of the urethra. Urethral strictures can be caused by injury related trauma, bacteria or viral infections especially sexually transmitted diseases, scar tissue from surgery, and the transmission of painful kidney stones. In babies, urethral strictures can result from circumcision. Symptoms of urethral strictures include decreased urinary stream, discharge from the urethra, enlarged or tender lymph nodes, and swelling. Urethral stricture can cause benign prostatic hyperplasia, Skene's gland, bilateral hydronephrosis, hernia, and urethral diverticulum.
There are currently no drug treatments for curing urethral strictures. Surgical treatments for urethral strictures include cytoscopy, urethrotomy, and urethroplasty. Cytoscopy consists of inserting an instrument into the urethra to widen it. In urethrotomy, small cuts are made in the urethra to widen it. Urethroplasty involves removal of the diseased portion and connection of the strictures if they are short or, for long strictures, implanting with tissue from the perineum or scrotum. After surgery, patients may have a stinging pain, small amounts of blood, and incontinence in urination. Patients may also have impaired sexual function, abdominal pains, and muscle spasms. Though these forms of surgery can be effective, surgery can be painful and risky.
Urethritis is an inflammatory infection of the urethra. Urethritis infections can arise from viruses such as adenovirus, herpes simplex viruses, Escherichia coli, chlamydia, gonorrhea, and mycoplasma genitalium. Other causative agents of urethritis include chemicals (contraceptive jellies and spermicides) and injuries. Symptoms of urethritis includes dysuria (painful or difficult urination), abdominal pain, blood in the urine, discharge, fever, recurrent or/and urgent urination, itching, tenderness, swelling in the groin area, and pain with intercourse.
Various drugs can be used to treat urethritis including co-trimoxazole and metronidazole. Co-trimoxazole has adverse side effects including upset stomach, fever, mouth sores, skin rash, and yellowing of the skin or/and eyes. Once again, metronidazole has the above-mentioned adverse side effects.
Sporkenbach et al. (“Sporkenbach”), U.S. Pat. No. 4,404,191, discloses a viricide technique for inactivating viruses on animate and inanimate surfaces by contacting the surfaces with a salt of peroxymonosulfuric acid (H2SO5) commonly known as Caro's acid. The peroxymonosulfuric acid salt, applied from an aqueous solution, can be a salt of an alkali metal such as potassium, sodium, or lithium, a salt of an alkaline earth metal such as calcium or magnesium, or an ammonium salt. Sporkenbach preferably employs KHSO5 as the peroxymonosulfuric acid salt. KHSO5 is provided from the mixed triple salt having the chemical formula 2KHSO5.KHSO4.K2SO4 where KHSO4 is potassium hydrogen sulfate and K2SO4 is potassium sulfate sometimes referred to as dipotassium sulfate.
KHSO5 and 2KHSO5.KHSO4.K2SO4 each have multiple chemical names. Both KHSO5 and 2KHSO5.KHSO4.K2SO4 are commonly referred to as “potassium monopersulfate”. To avoid confusion, KHSO5 is referred to herein as “potassium hydrogen peroxymonosulfate” or simply “potassium peroxymonosulfate”. 2KHSO5.KHSO4.K2SO4 is referred to herein as “potassium monopersulfate triple salt” or sometimes simply as “potassium monopersulfate”.
Sporkenbach identifies poliovirus, coxsackie virus, simian vacuolating virus 40 and adenovirus as being inactivated by potassium hydrogen peroxymonosulfate. Poliovirus causes poliomyelitis. There are two forms of coxsackie virus, type A and type B. Coxsackie A virus causes hand, foot, and mouth disease, acute haemorrhagic conjunctivitis, herpangina, and aseptic meningitis which includes viral meningitis. Coxsackie B virus causes pleurodynia (Bornholm disease) and can induce aseptic meningitis and diabetes mellitus type 1. Simian vacuolating virus 40 can cause tumors and cancer. Adenovirus generally produces infections in the upper respiratory tract. Adenovirus infections often appear as gastroenteritis, conjunctivitis, cystitis, and rash illness. Symptoms of respiratory illness caused by adenovirus infection include acute viral nasopharyngitis, pneumonia, croup, and bronchitis.
Sporkenbach discloses that its viricide technique can disinfect inanimate surfaces such as walls, floors and work surfaces, hospital utensils, and surgical and dental instruments in industrial, domestic, and medical environments and animate surfaces such as the skin of human and non-human animals during presurgical preparation in human and veterinary medicine. While Sporkenbach's viricide technique may prevent the diseases caused by the preceding viruses from being contracted, Sporkenbach's technique does not help already-infected people recover from those diseases.
Auchincloss, U.S. Pat. No. 4,822,512, discloses a dry water-soluble biocide for inactivating certain types of viruses, bacteria, and mold on non-human animals, specifically chickens, pigs, cows, and horses. The biocide contains (a) 0.01 to 5 parts by weight of a water-soluble inorganic halide, (b) 25 to 60 parts by weight of an oxidizing agent which reacts, in aqueous solution, with the halide to generate hypohalite ions, (c) 3 to 8 parts by weight of sulfamic acid, and (d) 10 to 30 parts by weight of an anhydrous alkali metal phosphate subject to the total parts totaling 100. The biocide may include up to 20 parts by weight of a non-reducing organic acid and up to 20 parts by weight of an organic surfactant.
The preferred oxidizing agent in Auchincloss's biocide is a persulfate or a peroxyphthalate. A persulfate is a sulfur-oxygen-containing compound having more oxygen than a normal sulfate. The additional oxygen in a persulfate is present in the form of one or more peroxide units, a peroxide being a chemical compound which includes an oxygen-oxygen single bond. The main types of persulfates are peroxymonosulfates and peroxydisulfates. A peroxyphthalate is a compound having more oxygen than a normal phthalate, the additional oxygen likewise being present in the form of one or more peroxide units.
Auchincloss's oxidizing agent is normally potassium monopersulfate triple salt, i.e., 2KHSO5.KHSO4.K2SO4. The halide is preferably sodium chloride but can be potassium chloride, potassium bromide, potassium iodide, sodium bromide, or sodium iodide. The organic acid is preferably malic or succinic acid. The alkali metal phosphate can be any one of sodium hexametaphosphate, monosodium phosphate, disodium phosphate, trisodium phosphate, tetrasodium pyrophosphate, monopotassium phosphate, dipotassium phosphate, tripotassium phosphate, and tetrapotassium pyrophosphate. According to Auchincloss, one embodiment of the biocide apparently consisted of 1.5 parts of sodium chloride, 50 parts of potassium monopersulfate triple salt, 10 parts of sulfamic acid, 5 parts of malic or succinic acid, 18.5 parts of sodium hexametaphosphate and (possibly) other alkali metal phosphate, and 15 parts of sodium dodecylbenzene sulfonate as the surfactant.
Auchincloss reported generally good results in variously using its biocide to disinfect chickens, pigs, cows, and horses. Auchincloss also reported that chickens can drink the biocide (apparently without harm), the biocide is not a skin or eye irritant, it is possible to bathe in the biocide (likewise apparently without harm), and the biocide can be sprayed in occupied rooms without causing discomfort.
Potassium peroxymonosulfate triple salt used by Sporkenbach and Auchincloss is commercially available from various sources including E.I. Dupont de Nemours and Company under the trade name Oxone and United Initiators under the trade name Caroat. Potassium hydrogen peroxymonosulfate, the principal component of potassium peroxymonosulfate triple salt, is a strong oxidizing agent. For instance, potassium hydrogen peroxymonosulfate can convert halide ions into halogens, ferrous ions into ferric ions, manganous ions into manganic ions, and hydrogen peroxide into oxygen. Potassium hydrogen peroxymonosulfate can also initiate the free radical polymerization of vinyl monomers such as vinyl acetate, ethyl acrylate, and acrylonitrile. In addition to the uses mentioned above, potassium hydrogen peroxymonosulfate serves as a bleaching agent in denture cleansers, toilet-bowl cleaners, and laundry/dry bleaches.
Valliéres, U.S. Pat. No. 5,186,946, discloses a disinfectant reportedly effective against bacteria, fungi, bacterial and fungal spores, and viruses. Somewhat similar to Auchincloss's composition, Valliéres' disinfectant consists of 60 to 90 weight % potassium hydrogen peroxymonosulfate, 2-10 weight % malic acid, 2-6 weight % sulfamic acid, 0.25-3 weight % ethylene diamine tetraacetic acid disodium salt , and 1-15 weight % alkylated ether of polyethylene glycol surfactant. Different from Auchincloss, Valliéres avoids the chlorine present in the sodium chloride preferably used by Auchincloss to implement the inorganic halide in Auchincloss's biocide. Valliéres states that its disinfectant is to be used for cleaning instruments, floors, and bedding in hospitals, bio-medical research centers, health centers, veterinary hospitals, and clinics.
Potassium hydrogen peroxymonosulfate is also used for removing chloramines in swimming pools. Regarding swimming pools, Lightcap et al. (“Lightcap”), U.S. Pat. No. 7,560,033 B2, discloses an anhydrous composition formed with potassium hydrogen peroxymonosulfate and an active halogen agent for sanitizing water in recirculating water systems such as swimming pools. The active halogen agent consists of an alkali metal salt of dichloro-s-triazinetrione or/and halogenated dimethylhydantoin. Lightcap reports that its composition inhibited the growth of algae in water and inactivated E. coli and Enterococcus faecium bacteria in water.
Randeri et al. (“Randeri”), U.S. Pat. No. 3,873,696 discloses that contact lenses can be effectively cleaned with a solution containing an oxygen-releasing salt such as a thiosulfate, a persulfate, or a peroxydisulfate. Randeri's preferred oxygen-releasing salt is potassium hydrogen peroxymonosulfate provided from a triple salt also containing potassium hydrogen sulfate (KHSO4) and potassium sulfate (K2SO4). Randeri's solution normally contains a chloride-ion-releasing salt such as sodium chloride.
Potassium monopersulfate triple salt of the chemical formula 2KHSO5.KHSO4.K2SO4 is an implementation of the more general chemical composition (KHSO5)x(KHSO4)y(K2SO4)z where x, y, and z are variable mole (or molar) fractions whose sum is 1. The general composition (KHSO5)x(KHSO4)y(K2SO4)z is referred to herein as “potassium monopersulfate triple salt composition” where the word “composition” distinguishes (KHSO5)x(KHSO4)y(K2SO4)z from the specific formulation 2KHSO5.KHSO4.K2SO4. When mole fractions x, y, and z respectively are 0.5, 0.25, and 0.25, the potassium monopersulfate triple salt composition (KHSO5)x(KHSO4(K2SO4)z becomes potassium monopersulfate triple salt of the formula 2KHSO5.KHSO4.K2SO4.
The weight (mass) fractions of potassium hydrogen peroxymonosulfate (KHSO5), potassium hydrogen sulfate (KHSO4), and potassium sulfate (K2SO4) respectively are roughly 45%, 25%, and 30% in a common formulation of potassium monopersulfate triple salt composition (KHSO5)x(KHSO4)y(K2SO4)z. The active oxygen content for this formulation is approximately 4.7%. A small percentage of potassium persulfate (or potassium perdisulfate) of the chemical formula K2S2O8 may be present in potassium peroxymonosulfate triple salt composition and in the specific potassium peroxymonosulfate triple salt. The potassium persulfate is generally undesirable because it reduces the active oxygen content, e.g., to 4.5%. A higher active oxygen content is often desired.
Potassium peroxymonosulfate triple salt composition (KHSO5)x(KHSO4)y(K2SO4)z, including potassium peroxymonosulfate triple salt 2KHSO5.KHSO4.K2SO4 itself, can be manufactured in various ways. Martin, U.S. Pat. No. 7,090,820 B2, discloses a technique for manufacturing the potassium monopersulfate triple salt composition (KHSO5)x(KHSO4)y(K2SO4)z with mole fractions x, y, and z adjusted to achieve an active oxygen content greater than 4.5% and with a reduced content of potassium persulfate. In a first embodiment, x is 0.43-0.64, y is 0.15-0.43, and z is 0.15-0.43. In a second embodiment, x is 0.46-0.64, y is 0.15-0.37, and z is 0.15-0.37.
Martin's process for manufacturing the potassium triple salt composition so that mole fractions x, y, and z fall into the ranges of the second embodiment entails adding a hydrogen peroxide solution containing at least 70% hydrogen peroxide by weight to a sulfuric acid solution containing at least 90% sulfuric acid by weight at a sulfuric-acid-to-hydrogen-peroxide ratio which is substoichiometric to produce a first Caro's acid solution containing peroxymonosulfuric acid (again, H2SO5) and hydrogen peroxide. The first Caro's acid solution is combined with oleum containing sulfuric acid and sulfur trioxide. The oleum reacts with water in the first Caro's acid solution to produce a second Caro's acid solution. An alkali potassium compound is added to the second Caro's acid solution to produce a partially neutralized solution containing potassium monopersulfate triple salt composition (KHSO5)x(KHSO4)y(K2SO4)z in which x, y, and z have values in the ranges of Martin's second embodiment.
Looking now at the background art in total, bacterial, eukaryotic, prion, and viral pathogens cause many diseases to human. Success in treating these diseases varies widely. While treatments for some of these diseases are essentially fully successful, treatments for others are only partially successful or do not currently exist. In particular, treatments for allergic rhinitis, arthritis, bronchitis, hemorrhoids, urticaria, toothache, tinea pedis, acute viral nasopharyngitis, herpes simplex, dandruff, itching, bromhidrosis, and vaginitis are commonly weak or non-existent. Even when treatments are fully or partially successful, there are often adverse side effects to the treatments.
Sporkenbach's technique of using a peroxymonosulfuric acid salt, preferably potassium hydrogen peroxymonosulfate, to inactivate certain viruses on animate and inanimate surfaces is an advancement. However, Sporkenbach's viricide technique is not useful in treating people to recover from the diseases caused by those viruses. It is desirable to have better technique for treating people infected with diseases caused by bacterial, eukaryotic, prion, and viral pathogens. It is especially desirable to have better techniques for treating allergic rhinitis, arthritis, bronchitis, hemorrhoids, urticaria, toothache, tinea pedis, acute viral nasopharyngitis, herpes simplex, dandruff, itching, bromhidrosis, and vaginitis without causing significant adverse side effects.